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PubMed2006

The effect of physical activity and physical fitness on plasma adiponectin in adults with predisposition to metabolic syndrome.

The purpose of this study was to measure changes in plasma adiponectin (ApN) over 24 months of exercise intervention in middle age adults with a predisposition to metabolic syndrome and to determine if changes in ApN were more affected by physical activity or physical fitness. Thirty-six subjects completed a 24 months home-based exercise program (cycling>or=three times per week, >or=45 min/session at 50-65% of VO2peak). Body composition, blood samples, and physical fitness were studied at baseline and after 12 and 24 months of participation in the study. The prescribed physical activity was monitored via self-reported exercise diary to determine MET levels, hours, and exercise compliance. Two-tailed repeated measures ANOVA and Spearman Rank Correlation Coefficients were used to detect significant differences and associations between the variables. ApN increased significantly (P<0.05) after 12 months in males (n=17; 5.3+/-1.9-7.0+/-3.0 microg ml-1) but not in females (n=9; 8.6+/-3.8-11.5+/-4.0 microg ml-1). The net change in ApN over 24 months was significantly correlated to the net change in VO2peak (physical fitness) (r=0.66; P<0.001), whereas exercise intensity was negatively correlated to DeltaApN over 12 months (r=-0.4; P<or=0.04) and 24 months (r=-0.45; P<or=0.02). Based on our results, an improvement in cardiorespiratory fitness of 15% increased plasma ApN concentration. Our findings suggest that moderate physical activity performed over many months induces positive changes in the plasma ApN concentration in adults with a predisposition to metabolic syndrome.

Adiponectin↗
PubMed1991

Leisure-time physical activity as an estimate of physical fitness: a validation study.

This paper describes a new interview questionnaire for the assessment of leisure-time physical activity (LTPA), and its validation as an alternative estimate of physical fitness. British subjects (77 males, 41 females) provided details of their LTPA over a period of a "typical" 2 weeks, enabling the estimation of the energy expended. Physical fitness was assessed with a battery of measures, the optimal single measure being sub-maximal physical work capacity (PWC). The questionnaire showed LTPA to be stable following test-retest administration (r = 0.86; p less than 0.0001) for total LTPA energy expenditure. Total LTPA was found to be significantly related to PWC (r = 0.48, p less than 0.0001), as were very hard (r = 0.55; p less than 0.0001) and hard LTPA (r = 0.38; p less than 0.0001). Multiple regression analysis with PWC as the dependent variable yielded a multiple correlation of r = 0.87, with significant contributions from very hard and hard LTPA. It is concluded that whilst this questionnaire is both reliable and a valid estimate of physical fitness amongst a population consistent in their leisure-time physical activities, there is scope for its further use within larger populations, allowing for an analysis of the effects of age and gender on the associations so far observed.

Adolescent↗
PubMed1999

Physical work load in physical education teachers.

The main objective was to measure and quantify exposure to physical work load in physical education teachers. A further aim was to establish the reproducibility of a three-week test-retest interval of self-reported physical load and to evaluate the agreement between registered and self-rated physical load. Thirty teachers, both female and male, volunteered to participate in the study. The physical load on the lower extremities, as well as the back and the cardio-vascular strain was recorded during one working day. The results indicate that the physical work load in this occupational group is considerable due to the load on the lower extremities. The demands of the cardio-vascular system are also relatively high in comparison to other occupational groups. The teachers could assess their activity quite well regarding heavy lifting and time spent sitting.

Adult↗
PubMed2002

Physical health correlates of overprediction of physical discomfort during exercise.

This study sought to determine if overprediction of physical discomfort prior to and following exercise was related to a number of self-report and objective measures of physical health status in a general population sample. Cross-sectional findings indicated a significant and specific relation between patterns of discomfort overprediction (vs under- or accurate prediction) and negative self-reported health status and attitudes to exercise, lower levels of physical activity, as well as poorer scores for resting heart rate, cardiorespiratory fitness and body mass index (but not waist:hip ratio). Females were more likely to overpredict discomfort, were less active and had poorer physical health than males. The potential usefulness of the prediction match-mismatch paradigm for studying exercise-related appraisal processes as proximal determinants of physical activity are discussed. Information obtained from such studies could prove useful in public health education campaigns aimed at increasing levels of physical activity in the general population, particularly among the less active.

Adult↗
PubMed2001

Physical activity and determinants of physical activity in obese and non-obese children.

OBJECTIVE: To compare the physical activity (PA) patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children. DESIGN: Cross-sectional study. SUBJECTS: One-hundred and thirty-three non-obese and 54 obese sixth grade children (mean age of 11.4+/-0.6). Obesity status determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES-1. MEASUREMENTS: Objective measurements were collected of PA over a 7-day period using the CSA 7164 accelerometer: total daily counts; daily moderate (3-5.9 METs) physical activity (MPA); daily vigorous physical activity (> or =6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (> or =3 METs, MVPA). Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games. RESULTS: Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10 and 20 min bouts of MVPA. Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active. CONCLUSIONS: The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity. Interventions to promote PA in obese children should endeavor to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modeling of PA.

Australia↗
PubMed2006

Physical performance, body weight and BMI of young adults in Germany 2000 - 2004: results of the physical-fitness-test study.

In westernized countries the sedentary lifestyle in conjunction with a hypercaloric diet has caused an increase in the number of obese adults. Moreover, recent studies suggest that the prevalence of overweight in children increased during the last decade. However, the literature has to be interpreted with some caution since the majority of epidemiological studies examining health, fitness, and obesity rely on self-reported data rather than measurements. A further limitation is that most studies examine either physical activity or nutrition, only few deal with both aspects simultaneously. In the present study we analyzed both aspects in more than 58,000 persons aged between 17 and 26 years. All of them were applicants for the German Bundeswehr, which accepts only volunteers with school leaving certificates and a body mass index (BMI) below 30 kg . m (-2). The admitted subjects performed a Physical-Fitness-Test (PFT) consisting of 5 simple sport tests (shuttle run, sit-ups, push-ups, standing jump, Cooper test). For 23 000 subjects additional measurements of body height and body weight as well as information about their education level were available. These data were combined with the PFT results. We found large deficits in the physical fitness of young adults: More than 37 % of the participants failed to pass the PFT, with failure rates of the male volunteers increasing significantly since 2001. While the female volunteers showed virtually constant body weight and BMI, the corresponding values of men increased monotonously between the age of 17 and 26 years. Physical fitness was positively, BMI negatively correlated with education level. The present findings suggest that body weight increases and fitness decreases in non-obese young adults in Germany. Despite the correlations between BMI and physical fitness the terms "overweight" and "physically unfit" should not be regarded as synonyms.

Adolescent↗
PubMed1998

Levels of physical activity, physical fitness and their relationship in the Northern Ireland Health and Activity Survey.

The aim of the study was to describe the physical activity and physical fitness profile of the population of Northern Ireland and to explore the relationship between physical activity and physical fitness. This was a cross sectional population study using a two stage probability sample of the adult population of Northern Ireland (aged 16+). The main outcome measures were physical activity profile based on computer assisted interview. Physical fitness using estimation of VO2max by extrapolation from submaximal oxygen uptake while walking on a motor driven treadmill. We found that males were more vigorously active than females (M 21%:F 6%) with a steep gradient of decreasing activity with age: 49% (M 52%:F 46%) were regularly active up to at least moderate intensity. Males (mean predicted VO2max 44.4 mls/kg/min; 16-74 years) were fitter than females (mean predicted VO2max 34.0 mls/kg/min; 16-74 years) and while there was a decline in predicted VO2max with age, there was wide variation within each age category. There was no statistically significant relationship between current or past activity and fitness after adjustment for possible confounding factors, with the exception of a relationship between fitness and activity in males so that the difference between no activity and habitual vigorous activity in predicted VO2max was 4.4mls/kg/min (10.1%).

Adolescent↗
PubMed2003

Physical activity and situational motivation in physical education: influence of the motivational climate and perceived ability.

The influence of perceptions of the motivational climate and perceived ability on situational motivation and the physical activity behavior of 213 male and 229 female adolescent physical education students (M age = 12.56 years; SD = 0.96) was examined over a 3-day period. A significant age by gender interaction emerged, with physical activity declining from the sixth to eighth grade. The decline was more pronounced among female than male students. Perceptions of a mastery climate were strongly related to more self-determined forms of situational motivation. In contrast, perceptions of a performance climate were strongly related to less self-determined forms of situational motivation. Results of a hierarchical regression analysis revealed gender, perceived ability, and perceptions of a mastery climate to explain a significant amount of variance in physical activity. These findings suggest that promoting a mastery oriented motivational climate in physical education will foster self-determined situational motivation and physical activity.

Adolescent↗
PubMed2004

Leisure-time physical activity and secondary conditions in women with physical disabilities.

PURPOSE: To examine the relationship between secondary conditions and leisure-time physical activity participation (LTPA) in women with physical disabilities. METHOD: A survey was conducted in a metropolitan urban USA area of women (n=170) with physical disabilities including MS, CP, polio, arthritis, TBI, and CVA among others and aged 21-65 years. Outcome measures were LTPA, secondary conditions (numbers and severity), and functional status. RESULTS: Respondents experienced 11.99 (+/-6.05) secondary conditions in the past year, self-rated their severity as 'moderate problems', and reported moderate levels of functional impairment. LTPA participation (excluding calisthenics/exercise) was reported to be 2.90 (+/-5.12) times/week with 39.4% reporting no participation. After controlling for the interaction between severity of secondary conditions and functional status, the secondary conditions of physical deconditioning and isolation were significantly and inversely related to LTPA participation (r=-0.164, p=0.036; r=-0.156, p=0.045, respectively). CONCLUSION: Reported secondary conditions of physical deconditioning and isolation are inversely related to the ability of moderately impaired women with physical disabilities to participate in LTPA when functional status was controlled and should be considered in efforts to increase involvement in this health promoting behaviour.

Adult↗
PubMed1994

Physical disablement concepts for physical therapy research and practice.

Disability, one of modern society's greatest public health problems, affects individuals, families, and society. Understanding the complex process of disablement, therefore, is critical given the current and projected increases in disability. Terminology in the field of disablement continues to breed confusion and controversy across and within disciplines. This article discusses some of the major models that have been developed to guide physical therapy researchers and clinicians in their thinking about disablement. Emphasis is on physical disablement because of its central role in physical therapy research and practice. Detailed descriptions are provided for two disablement formulations. One was developed in the 1960s by sociologist Saad Nagi. The other is the International Classification of Impairments, Disabilities, and Handicaps, developed for the World Health Organization. Both can serve as the basic conceptual architecture for disablement research in physical therapy. Researchers and clinicians need a common vocabulary and language for thinking and speaking about the process of disablement, although it appears premature to reach consensus on any one conceptual approach. Physical therapists should play an active role in guiding future research and scholarship on physical disablement.

Activities of Daily Living↗
PubMed1994

Physical therapists' perceptions of the roles of the physical therapist assistant.

BACKGROUND AND PURPOSE: This longitudinal study investigated physical therapists' perceptions of the roles of physical therapist assistants (PTAs). METHODS AND SUBJECTS: In 1986, a questionnaire describing 79 physical therapy activities was distributed to a random sample (n = 400) of physical therapists derived from the American Physical Therapy Association (APTA) membership. In 1992, a similar questionnaire was distributed to a representative sample (n = 400) of physical therapists derived from the APTA membership. Response rates were 53% and 55% in 1986 and 1992, respectively. Respondents indicated whether each activity was included in the documentation describing PTA roles. RESULTS: Results revealed considerable agreement between therapists' perceptions of PTA roles and those outlined by PTA practice guidelines, and these perceptions changed little over time. Discriminant analyses suggested that therapists' perceptions of PTA roles were, in general, not predicted by supervisory experience with PTAs, therapist experience, or content of entry-level professional education curricula. CONCLUSION AND DISCUSSION: Generally, therapists' perceptions of PTA roles are consistent with published practice guidelines. Therapists' perceptions on selected activities, however, were incongruent with PTA practice guidelines, suggesting the potential for inefficient or inappropriate utilization of the PTA in the delivery of selected services.

Allied Health Personnel↗
PubMed1998

Performance following ability-focused physical therapy intervention in individuals with severely limited physical and cognitive abilities.

BACKGROUND AND PURPOSE: Do individuals with severely limited physical and cognitive abilities improve their gross motor abilities when given physical therapy intervention, and does improvement transfer to nontreatment settings? SUBJECTS: The subjects were 24 individuals (10 female, 14 male), aged 3 to 30 years (X = 20.1, SD = 8.1), who were nonambulatory and had limited adaptive behavior. METHODS: Change in gross motor ability during 18 weeks of twice-weekly therapy was measured using goal attainment scaling (GAS). Three gross motor goals were developed for each subject based on individual or caregiver needs, with one goal randomly selected as a control. Physical impairments were treated, and behavioral management principles, low-level communication approaches, high-repetition practice of goals, and a progressive reduction of both physical assistance and multisensory cues were used. An independent rater scored goal level from randomly ordered videotapes recorded during therapy and in recess and home settings. RESULTS: Mean GAS T scores were higher for treatment goals (X = 45.6, SD = 10.5) compared with control goals (X = 34.6, SD = 11.8). When the expected goal level (50) was met during therapy, mean GAS T scores in recess settings ( X = 35.9, SD = 11.5) and home settings (X = 42.2, SD = 12.2) were lower. At the conclusion of therapy, there were no differences in goal levels between treatment and control goals in both the recess and home settings. CONCLUSION AND DISCUSSION: The subjects demonstrated improvement of gross motor abilities practiced during therapy. Level of ability during therapy, however, did not consistently transfer to the recess of home settings. [Brown DA, Effgen SK, Palisano RJ. Performance following ability-focused physical therapy intervention in individuals with severely limited physical and cognitive abilities.

Adolescent↗
PubMed1999

Childhood and adolescent physical activity patterns and adult physical activity.

PURPOSE: A major research priority is the influence of childhood and adolescent physical activity patterns on adult physical activity. The research in this area is inconsistent. Therefore, the purpose of this study was to evaluate the relationships among specific components of physical activity during childhood and adolescence and exercise habits in adulthood. METHODS: We analyzed preteen and teenage experiences, individual and team sports, and several psychosocial variables. One hundred and five male volunteers completed questionnaires about their current (estimated energy expenditure (EE)) and historic physical activity and a treadmill stress test. RESULTS: Based on correlations and regression analyses, without and with controlling for potentially confounding variables (treadmill run time and sum of skinfolds), the frequency of being forced to exercise and the frequency of being encouraged to exercise during the preteen years were inversely related to adult physical activity. Being forced to exercise during the preteen years was more related to participation in individual sports than to participation in team sports or both individual and team sports. CONCLUSIONS: Being forced to exercise during childhood may have potentially negative consequences for later activity. The findings indicate that experiences related to participation in activity during childhood and adolescence may influence adult physical activity. The implications of our findings are discussed and future research is recommended.

Adolescent↗
PubMed2002

A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study.

STUDY DESIGN: A randomized clinical trial. OBJECTIVES: To compare the effectiveness of medical and chiropractic care for low back pain patients in managed care; to assess the effectiveness of physical therapy among medical patients; and to assess the effectiveness of physical modalities among chiropractic patients. SUMMARY OF BACKGROUND DATA: Despite the burden that low back pain places on patients, providers, and society, the relative effectiveness of common treatment strategies offered in managed care is unknown. METHODS: Low back pain patients presenting to a large managed care facility from October 30, 1995, through November 9, 1998, were randomly assigned in a balanced design to medical care with and without physical therapy and to chiropractic care with and without physical modalities. The primary outcome variables are average and most severe low back pain intensity in the past week, assessed with 0 to 10 numerical rating scales, and low back-related disability, assessed with the 24-item Roland-Morris Disability Questionnaire. RESULTS: Of 1,469 eligible patients, 681 were enrolled; 95.7% were followed through 6 months. The mean changes in low back pain intensity and disability of participants in the medical and chiropractic care-only groups were similar at each follow-up assessment (adjusted mean differences at 6 months for most severe pain, 0.27, 95% confidence interval, -0.32-0.86; average pain, 0.22, -0.25-0.69; and disability, 0.75, -0.29-1.79). Physical therapy yielded somewhat better 6-month disability outcomes than did medical care alone (1.26, 0.20-2.32). CONCLUSIONS: After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness. Physical therapy may be marginally more effective than medical care alone for reducing disability in some patients, but the possible benefit is small.

Analgesics↗
PubMed1992

Physical fitness or physical activity as a predictor of ischaemic heart disease? A 17-year follow-up in the Copenhagen Male Study.

Physical fitness and leisure time physical activity are strongly correlated, and both are inversely correlated with risk of ischaemic heart disease. Does this mean, however, that a very fit man has a lower risk of ischaemic heart disease (IHD), even if he is inactive? And does it also mean that an unfit, but active man, does not have a lower risk of IHD than an unfit, inactive man? In the Copenhagen Male Study, we analysed the joint effect of fitness and leisure time activity. In 1970/71, 4999 men aged 40-59 years, were classified according to level of physical fitness, i.e. indirectly measured maximal oxygen uptake, and physical activity, and their mortality was recorded over the following 17 years. In sedentary men, fitness was no predictor of future risk of IHD whatsoever. Age-adjusted baseline values were similar in later IHD cases and survivors (32.3 and 32.1 ml O2 kg-1 min-1, respectively: P = 0.91). In medium or highly active men, however, fitness was a strong predictor. The corresponding fitness values were 33.1 and 34.8 ml O2 kg-1 min-1 (P < 0.001). The least fit (two least fit quintiles) physically active men had a lower IHD mortality rate (6%) than the least fit sedentary men (10%). Adjusted for age, social class and smoking in a multiple logistic regression equation, this was estimated to an RR (95% C.I.) of 1.67 (1.06-2.64) (P = 0.027). The two major new findings of this study were (a) that being very fit, provides no protection against IHD--nor all-cause mortality--in sedentary men, and (b) that unfit but sedentary men have a higher risk of IHD than unfit but active men, i.e. those performing light physical activity for at least 4 h per week.

Adult↗
PubMed2000

Relationship between physical activity recall and free-living daily physical activity in older claudicants.

The purposes of this study were to determine the relationship between the physical activity values obtained from the peripheral arterial disease-physical activity recall (PAD-PAR) questionnaire and (1) the free-living daily physical activity obtained from the doubly labeled water technique and (2) clinical measures of PAD severity. Fifty-one older PAD patients (age= 70 +/- 6 years) were recruited from the Vascular Clinic at the Baltimore Veterans Affairs Medical Center and from radio and newspaper advertisements. Energy expenditure of physical activity (EEPA) was determined by using doubly labeled water and indirect calorimetry techniques. PAD severity was measured by ankle/brachial index (ABI) and walking distance to maximal claudication pain determined during a graded treadmill test. In addition, patients were also characterized on body composition and total daily energy expenditure. The physical activity values obtained from the PAD-PAR questionnaire (113 +/- 37 MET-hr/wk) were not related to EEPA (542 +/- 260 kcal/day; r= -0.057, p=0.690), ABI (0.64 +/- 0.19; r=0.032, p=0.826), or distance to maximal claudication pain (376 +/- 229 m; r=-0.054, p=0.731). The authors conclude that the PAD-PAR questionnaire is not an accurate measurement of free-living daily physical activity when compared to EEPA by use of the criterion method of doubly labeled water, and the activity questionnaire measures were poorly correlated with clinical measures of PAD severity.

Activities of Daily Living↗
PubMed2003

Quantifying physical activity via pedometry in elementary physical education.

PURPOSE: The objective of this study was to determine a pedometer steps per minute standard for quantifying the lesson time that first- and second-grade physical education students spent in moderate to vigorous physical activity (MVPA). METHODS: The sample was divided into validation (N = 246) and cross-validation (N = 123) samples using the holdout technique. Using the criterion test model, steps per minute cut points were empirically and judgmentally determined. C-SOFIT systematic observation was the criterion instrument and pedometry was the predictor instrument. Data were collected from 45 physical education lessons implemented in six schools. The three-step analytic procedure of computing mastery/nonmastery outcome probabilities, phi coefficients, and error proportions was used to determine the optimal steps per minute cut point for quantifying 33.33% of the physical education lesson time engaged in MVPA within a 30 class. RESULTS: Steps per minute was highly correlated with observation (r = 0.74-0.86, P < 0.0001). Five steps per minute scores that were accurate indicators of 33.33% of the class time engaged in MVPA in the validation sample were accurate indicators of steps per minute in the cross-validation sample. The optimal steps per minute cut point ranged from 60.00 to 63.00, which is equivalent to 1800-1890 steps in a 30-min physical education class. CONCLUSION: Data supports the use of pedometry steps per minute values as an accurate indicator of MVPA. Pedometry demonstrates promise as a viable large-scale surveillance instrument for measuring MVPA in physical education.

Child↗
PubMed2006

Tracking of physical fitness and physical activity from youth to adulthood in females.

PURPOSE: To evaluate stability of physical fitness and physical activity from adolescence into middle adulthood in Flemish females. METHODS: Within the scope of the Leuven Longitudinal Study on Lifestyle, Fitness and Health, 138 females (mean age=16.6+/-1.1 yr) from the Leuven Growth Study of Flemish Girls were seen in adulthood (mean age=40.5+/-1.1 yr). Several body dimensions and motor fitness tests were taken. Physical activity was assessed by means of a sports participation inventory. Inter-age correlations were calculated between adolescent and adult values. Cross-tabulation was used to identify the percentage of subjects remaining in the same BMI and physical activity group or shifting from one group to another from adolescence to adulthood. Odds ratios for less activity and overweight in adulthood according to adolescent activity or weight status were calculated. RESULTS: Except for flamingo balance, plate tapping, leg lifts, and arm pull, all anthropometric and physical fitness characteristics were stable from adolescence to adulthood (r ranging from 0.49 to 0.96). Sports participation was not a stable characteristic (r=0.13). From adolescence to adulthood, 84.5 and 63.6%, respectively, remained in the normal-weight and overweight group, whereas 62.5 and 54.4%, respectively, remained in the less active and active group. The odds of being overweight in adulthood was 9.53 (95% CI: 3.1-29.8) times greater in overweight compared with normal-weight adolescent girls. CONCLUSION: In Flemish females, anthropometric and fitness characteristics demonstrate higher levels of stability from adolescence to middle adulthood than physical activity. Weight status during adolescence is indicative of adult weight status, and a pattern of less activity rather than activity tends to continue from youth to adulthood.

Adolescent↗